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Updated: Jan 14, 2026
A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
Extended surveillance after piecemeal endoscopic mucosal resection: a safe approach to initial surveillance in
Nikhita J Perry1, Sai Bhatte1, Joseph R Triggs2
1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background And Aims:
Piecemeal endoscopic mucosal resection (EMR) is the standard of care for large, nonpedunculated colon polyps but is associated with recurrence rates of 9% to 31%. Current guidelines recommend 6-month surveillance for all patients, although this may not be necessary for lower-risk cases.
Methods:
We retrospectively reviewed patients who underwent piecemeal EMR of ≥20-mm colon polyps between 2018 and 2021. Patients were stratified into 6- or 12-month surveillance groups based on polyp features. Recurrence rates and associated factors were compared.
Results:
Among 193 patients, recurrence was higher in the 6-month (31.5%) than in the 12-month group (14.3%, P < .05). Among patients with recurrence, the 6-month follow-up group had more tubulovillous adenomas (P < .05) on index colonoscopy. Tubulovillous histology in the initial polyp was the only factor associated with recurrence.
Conclusions:
A risk-stratified approach may safely extend surveillance to 12 months for lower-risk patients after piecemeal EMR, reducing unnecessary procedures without compromising care.
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